So sick, so tiny, and so alone
Covid-19’s terrible impact on premature babies in intensive care
PARENTS and healthcare workers are finding new visitor restrictions for sick babies distressing but say they are necessary to protect our most vulnerable newborns during the coronavirus pandemic.
Precautions in place to keep premature babies and irreplaceable neonatal staff healthy as Covid-19 rages mean mothers can only visit their babies in neonatal intensive care units (NICUs) for 15 minutes a day in some units, with fathers and partners unable to visit their sick children in most cases.
Midwives from Ireland’s biggest maternity hospitals have told the Irish Mail on Sunday that it goes against everything they usually practise to have to keep parents away from their babies.
Director of Midwifery at the Rotunda Fiona Hanrahan told the MoS: ‘The one thing that has kept me awake at night during all this is the fear of one of our babies contracting Covid-19 or it running through our units and taking out our staff. Neonatal staffing is such a specialised area – we can’t just put anyone in to work in neonatal intensive care. Our buildings here are very old, it isn’t possible to distance yourself from anyone in the NICU because the space is tight.’
She added: ‘We had to make a very difficult decision to reduce the visiting and the footfall in the NICU.
‘We knew we couldn’t take any risks. Premature babies have zero immune system.’
In the Rotunda, parents of babies in NICU are being provided with iPads and the staff send videos and
‘Premature babies have zero immune system’
photo updates on their babies during the day. Typically, mothers can visit for half an hour but this can be adjusted on a case-by-case basis. The father is also permitted to visit if the baby is critically unwell.
The biggest NICU units are the Rotunda, the Coombe, the National Maternity Hospital (NMH) at Holles Street and Cork University Maternity Hospital. These hospitals tend to deal with the sickest babies while there are 15 other smaller NICUs across the country.
Luckily, mothers presenting with Covid-19 or suspected Covid-19 have not been very ill so far, according to both the Rotunda and the National Maternity Hospital directors of midwifery.
Only 12 out of around 700 women have been Covid-positive in the NMH over the last number of weeks. There has been one case in the Rotunda and a small number of suspected cases.
In the NMH neonatal units, the visiting hours have been restricted to 15 minutes for mothers per day, to minimise transmission.
Director of Midwifery at the NMH, Mary Brosnan, described it as the ‘hardest part’ of the measures they have put in place to date in response to the pandemic.
Ms Brosnan said: ‘Women and partners are getting two to three hours a day to view their baby; it doesn’t replace individual, physical time but has helped enormously.’
She added: ‘Some staff in the neonatal have been doing overtime, some have been coming in on their holidays to manage it. People have been amazing. Some people have moved out of their family homes so as to prevent any exposure at all, it’s incredible.’
But concerns have been raised by the Irish Neonatal Health Alliance (INHA) about the restrictions put in place. It advocates for premature babies and their families.
Head of advocacy and policymaking for the INHA, Mandy Daly, told the MoS that there were a number of issues at play.
She said: ‘We’re looking at recommendations from WHO and UNICEF that insist that breastfeeding and skin to skin contact with parents continue.
‘We haven’t paid attention to that advice in this country.
‘We’ve seen varying restrictions placed by different hospitals based on fear, fear for the babies, fear for the staff, particularly neonatal staff who are specialist, but we need to have a conversation about how these restrictions will impact babies in the long term.
‘The infrastructure for social distancing may not be there in a lot of units but the Coombe has come up with a visitor rotation to keep parental access open.’
Another solution may be to provide parents with PPE and allow them to provide care for their baby while in the neonatal unit.
Ms Daly added: ‘It’s clear from these restrictions that our neonatal units need to be revamped, so that social distancing will not be an issue in the future. We need to look at the long-term effects of this.’